Tuberculosis Surveillance of Hospital Personnel

Tuberculosis continues to present a problem of exposure for both patients and personnel in the general hospital. While not frequent, it is not uncommon and often is initially unsuspected, resulting in significant delay in diagnosis and the possibility of many potential contacts. We have reviewed our experience with tuberculosis surveillance at the Ohio State University Hospitals with the following conclusions: (1) Skin testing is a cost-effective means of surveillance of personnel, but requires proper interpretation. (2) Apparently high conversion rates may result from an undocumented history of tuberculin status or the booster effect of repeated testing. (3) Annual chest roentgenograms are expensive, have limited value, and entail some radiation exposure. (4) Isoniazid prophylaxis has been shown to be effective in reducing later reactivation of primary tuberculosis. (5) Based on our experience and other available data, it appears appropriate to eliminate routine periodic chest films on tuberculin-positive individuals who have undergone isoniazid therapy unless additional risk factors are present.